18 Facts on Breast Cancer and Treatment Protocols

A cancer diagnosis is incredibly terrifying. People know that there is always a possibility of getting cancer, but they never think that it will happen to… Simi - August 6, 2018

A cancer diagnosis is incredibly terrifying. People know that there is always a possibility of getting cancer, but they never think that it will happen to them. While the disease itself may be well known, the specifics are a lot more obscure. Barring oncologists and other medical professionals, most people cannot tell between the several types of cancers, and they don’t know much about the several treatment options.

Sure, people know that tumors can be removed during surgery and that most cancer patients will need to undergo some chemotherapy or radiation therapy. But not all cancers are equal. While many types can be life-threatening, a cancer diagnosis is not necessarily a death sentence. What’s more, as technology and medical procedures advance cancer is becoming more and more treatable.

The recovery process may be long, and it may be hard, but recovery is possible. When a woman gets breast cancer, she gets bombarded with thoughts that spell doom and gloom. But, if she has gets diagnosed with ductal carcinoma in situ, then this could not be further from the truth.

This is a type of breast cancer that is incredibly treatable. It may be scary yes, it is cancer after all. But it is cancer that is caught early, and it is one that is quite well understood. One way to alleviate some of the stress that accompanies a cancer diagnosis is to eliminate the mystery and misinformation that surrounds the topic. Therefore, here are some things that everyone needs to know about ductal carcinoma in situ.

Cancer develops in the milk ducts

As the name suggests in ductal carcinoma in situ, cancer itself develops in the milk ducts of the breast. These ducts are responsible for transporting milk from the breast to the baby that gets fed. When a cell in this region becomes cancerous, it multiplies incorrectly and then results in a clump of cells that could resemble a tumor. This may sound like it could be terminal, but the position of this cancer makes it quite a treatable one. Because cancer develops in the ducts, it is also confined to these same ducts. It is not likely to spread, and that is why it has the stage classification of stage 0.

This is very low down on the cancer staging scale and can even be referred to as pre-cancer. This situation can be verified by again referring to the name of cancer. In situ means that it is in its original place, therefore stopping it from metastasizing cancer. In women who have received their breast cancer diagnosis early, a fifth of them has ductal carcinoma in situ.

It is not a cancer

This is not said to invalidate the fear and trepidation that is felt following a diagnosis of DCIS. It is still an awful experience. Each person that has received this diagnosis is well within their rights to be upset. They can be scared, and they can be sad. But once they have let these emotions wash over them, it is time to have a serious talk about the fact that this is not cancer. Yes, the wording of DCIS may imply that it is cancer. But, when it comes down to semantics, proper cancer needs room to grow and spread.

DCIS happens in the milk ducts of the breasts and is therefore confined to these ducts. Therefore, this is not cancer. It is not invasive like other breast cancers. It is a deviation from the proper functioning of the body, but it is not cancer. This point cannot be stressed enough. This doesn’t mean that it is not a severe condition, but people with this diagnosis need to be aware that they have not been given a death sentence. They have been given a diagnosis of a disease that is very treatable.

A mammogram is needed to find the cells

Women should be in the habit of getting routine mammograms. This does not have to be done excessively. But, it is a very important checkup that should be performed at least once a year. The process may be quite uncomfortable, and it could even hurt, but it is not invasive, and it should not be avoided out of fear. It is during these mammograms that DCIS is generally picked up. It shows up as a calcified area in the breast. If this is found, then a sample will be taken for a biopsy. This biopsy will then confirm or deny whether DCIS is present or not.

This is an apparent indication of the importance of mammograms as in the case of DCIS, and lumps are generally not big enough to be felt. They are not noticeable, and they mostly cannot be detected just my feeling around the breast. Granted, there are cases where a lump can be felt, and it is possible to have an unusual discharge from the nipple when one has DCIS. But, on a whole, a mammogram is needed to detect the condition. There is also Paget’s disease where the skin around the nipple gets dry and thick, which is associated with DCIS.

Detection has become better in recent years

Just two decades ago, there weren’t that many cases of early detection when it comes to DCIS. As with any cancer, early detection is of the most vital importance. This is because if cancer is caught early enough, then the treatment options increase as well as the chances of recovery. There are two reasons why more women are being diagnosed early when it comes to DCIS. The first is that technology is better. Better equipment means that tiny lesions are seen when they would have otherwise gone unnoticed.

The other reason why doctors are diagnosing more women with DCIS is that more women are getting routine mammograms. This procedure is no longer reserved for those who feel like there is something wrong. Women are not only going to doctors once they have found a lump or think that they need to be looked at. Mammograms are becoming more familiar with a higher number of women getting their breasts checked along with their other routine health inspections. The good thing about early detection is that the disease has not been given enough time to spread outside of the duct. This keeps the severity and stage of the disease down, making treatment easier and more effective.

It is very treatable

There has already been quite a lot that has been said about the fact that DCIS is a treatable disease. But, many diseases are treatable to some degree or other. The real thing that is in question here is how many people die from DCIS. If the disease is caught a bit later, what are the person’s chance of survival? This is what medical professionals refer to as a prognosis. It gives people an idea of what their chances are once they have received the treatment that is needed for their condition. While it is never great to be diagnosed with cancer, there is a silver lining with DCIS.

This silver lining is that the prognosis for people with DCIS is incredibly useful. In fact, regardless of the type of treatment option that is chosen, the prognosis for this disease is excellent. A study that was done on patients found that only 3% of DCIS patients died when they were observed over a period of 20 years. This value is very similar to the one that governs the general population. On the topic of cancer, these are some excellent odds.

There are some downsides to DCIS

DCIS is indeed not a fatal disease. It is one that can be managed very well, and people can go on to live very healthy lives after they have been treated. It is, however, a disease. It is not a very dangerous one, but it is a disease. The fact that a person has DCIS means that there is something wrong with the way that the cells in their breast were functioning. Just because the disease has been treated, it does not mean that there may not be an underlying problem that exists.

In the case of DCIS, the problem is that once the cells have been removed, there is a chance that another more invasive cancer may develop in the future. There is not much that is known about why this happens. But, there is a fair amount of evidence to suggest that once a person has had DCIS, they have a higher risk of developing different breast cancer. This could be because a problem may improve with the cells in another milk duct or a mutated cell has gone from the previously infected duct to one that was healthy. This same trend exists with both patients who have a lumpectomy and mastectomy.

Size is key with tumors

Following on from the previous point, it should not be surprising that there has been research done on why exactly people who have had DCIS have a higher risk for future cancers in their breasts. It is all well and good treating a person with cancer, but if you know that they might develop cancer again in the future, part of the treatment protocol would be to try and prevent this horrible occurrence from happening again. This is not a hard fact, but there is evidence to suggest that the size of the original tumor is what is essential when it comes to recurring cancer.

This is not a guessing thing when it comes to size and the exact data states that if the original tumor is more significant than 20 to 25 millimeters, then it is a good idea to pursue a more rigorous treatment regime. The first thing that needs to be done is that the tumor needs to be removed with surgery. Then there needs to be some chemotherapy or radiation therapy that is involved. This may be able to prevent the onset of future cancers, but in medicine, there are no real guarantees.

The actual tumor cells also matter

This may sound like it is stating the obvious, but tumor cells are not like normal cells. They do not function as healthy cells do, and they do not come about in a healthy way. A tumor cell comes about when a cell does not divide properly. The result is a cancerous cell that then divides itself and then produces a couple more cancerous cells. If this process is left to continue, then you have a full-blown tumor. These can apparently be removed via surgery and then there is chemotherapy and radiation therapy that’s sole aim is to find these abnormal cells and kill them.

On the topic of DCIS, the size of the original tumor may be important when it comes to figuring out if the patient may develop cancer in the future. But, this is not the only indicator. The other thing that is checked is the nuclei of the cells in the tumor. There are three different types. A grade 1 cell which is very similar to a normal cell, then a grade 2 cell which is slightly abnormal and finally a grade 3 cell which is fast-growing and very abnormal.

What about genetics?

As cancer becomes more prevalent in society, doctors have noticed a pattern. This pattern is that there are specific genes which can be passed on from parent to child that indicate a higher risk for cancer. There are 12 genes that doctors look at when they have patients who have been diagnosed with DCIS. The process works in the following way. Once a diagnosis of DCIS has been confirmed, the tumor gets removed, and then these cells are sent for testing at a laboratory.

Once the lab has been given these cells, they look at the 12 genes in question. These genes should indicate how likely it is for the patient to develop either another cancer in the future or more invasive breast cancer. Again, this is not exact. It is used more as a guideline, and it gives doctors an idea of the chances of future cancer. Once this information has been gathered, then the patient will at least have an idea of what the future may have installed for them. They have a better understanding of what might happen to their body according to what has been written in their DNA.

Surgery is an option

Tumors behave in a very odd way once they grow. One of the things that they do is encourage veins and arteries to develop in their direction. This might not sound like such a big deal at first but when one considers the fact that this then draws blood and nutrients from areas of the body that need them. Tumors do also not only affect the blood flow in the body, but they also affect the cells around them. Tumors are very poisonous to the body, and they need to be removed swiftly and timelessly. The way that this is generally done is via surgery.

When it is just the tumor that is removed from the breast, then it is called a lumpectomy. This involves removing the tumor along with two millimeters of cells around the tumor. These are healthy cells that get eliminated in an attempt to ensure that there is not a single cancerous cell that is left behind. This is not always an option if cancer has spread to multiple ducts. There are times when a mastectomy is prescribed. This involves removing a lot more than just the cancerous cells.

Radiation may be necessary

DCIS may not be real cancer when it comes down to semantics. But, the fact of the matter is that the cells are not healthy. They are not dividing properly, and there is no guarantee that it is not going to happen again. In fact, as it has been stated already, there is quite a significant chance that cancerous cells may develop still. It might occur in the breast again, or it could happen somewhere else. The point is that it can happen and doctors will do whatever possible to try to ensure that it won’t happen again.

Once the cancerous cells have been removed, there is a lot of testing that is done to try and determine what the chances of it happening again are. This is done by examining the cancer cells, taking a family history and testing the genes of the cancerous cells. Once all of this information has been collected, patients are given a score. A high value here means that they are at high risk of developing cancer again. Doctors do not just leave patients with this information. They may recommend radiation therapy in an attempt to prevent the recurrence of cancer.

Hormone-blocking medicine may be an option

It may sound like a cliché, but the fact of the matter is that prevention is better than cure. Not only is it better to keep a body healthy as opposed to trying to heal a sick one. With the way that medicine has been set up today, treatment for even the most minor of conditions can be costly. It is for these reasons that doctors do anything in their power to stop someone from getting sick. With DCIS, radiation therapy has already been discussed, and while this method could help prevent cancer from forming again, it can be hazardous. The other option that is open to patients is hormone therapy.

The way that this works is that the tumor cells are tested to see if they have estrogen and progesterone receptors. If this is the case, then the patient could benefit from taking medicine that works to block these hormones. Do not be mistaken, these drugs also come with their risks, and if the doctors feel that the patient won’t benefit from them greatly, then they will not recommend them at all. It should also be noted that this treatment does not prolong the life of the patients.

Chemo is not always prescribed

Chemotherapy is an incredibly invasive procedure. It is not pleasant, and if a person does not necessarily need it, then it should not be done at all. In fact, it should be entirely avoided if possible. It is not something that should be done just in case and will only ever be prescribed if doctors think that it could help. With DCIS, chemotherapy is almost never prescribed. To understand why one would first need to understand how chemotherapy works.

In unusually blunt terms, it is a poison that is sent circulating a person’s entire body. It is not targeted like some forms of radiation therapy can be. It is sent right into the bloodstream and then is left to traverse the entire body while it tries to find cancer cells to eradicate. Less than 1% of DCIS cases result in cancerous cells leaving their original site and migrating to another milk duct. In these cases, chemotherapy could be useful. But, only in these cases. Otherwise, it is a procedure that is harmful and comes with many horrible side effects. Even with people that have migrated cancerous cells, there is no guarantee that chemotherapy will help.

Men can get it too

When people discuss breast cancer, they always think of women. This is not entirely surprising when one considers the fact that only women have breasts. Men may have nipples, but they do not technically have breasts. It is because of this distinction that people think that men cannot get breast cancer but they actually can. In this case, it is all in the nipples. Men have nipples because their Y chromosome, which is what differentiates them from women, only kicks in once the nipples have been developed. This means that a male nipple is identical to a female nipple. They even have milk ducts, these are not functional, but they have them, and that is where the problem comes in.

They can develop cancerous cells in these milk ducts just like women. The other downside of this is that men do not have routine mammograms. They, therefore, do not detect DCIS very early on. In fact, it is generally not detected in men until it has grown to a size which can be physically felt. These types of tumors can be treated, and the treatment is very similar to the treatment that is prescribed for women.

DCIS is not based on age

Health professionals and health-centered people tend to go on and on about not increasing your risk of cancer by participating in risky behavior. They talk about how dangerous smoking is and how they should eat right less they get sick. These are all fair points. In fact, they are right. Many carcinogens in this world can increase a person’s risk of developing cancer. There is also risky behavior like going out in the sun without sunblock. Cancer is, however, not limited to carcinogens. There are people who kind of have cancer lingering in their genes. This does not mean that they will get it. It says that they are more likely to get it.

The result is that people can get cancer at any age. They can also get DCIS at any age. If a woman is diagnosed after the age of 40, then it is quite surprising that they do not have an increased risk of developing cancer again. It is younger women who are at risk. These women have generally been prescribed a more rigorous treatment protocol so that they can try to avoid developing cancer again in the future.

Risk factors are risk factors

Following on from the previous point, some people are more likely to develop cancer. There are times when these reasons have to do with lifestyle choices, but there are also a lot of factors that have nothing to do with how a person lives their life. There are times when people may develop cancer because of things that are entirely out of their control. These can include things like hitting puberty early or even starting menopause late. Then there are things like having a child after the age of 30 or not having children at all.

The body can be a very complicated thing and when it comes to cancer one cannot presume that it is the patient’s fault. Genes and biology, in general, do not always work in a woman’s favor. When it comes to DCIS, the risk factors that exist for it are the same as the risk factors that exist for other breast cancers. No one can tell what kind of breast cancer a woman is likely to get. They can say what the risk is, but they won’t know the type of cancer. This is unfair and unfortunate, but it is also, unfortunately, the way that it is.

But, lifestyle does matter

You are what you eat. There may have been a time when this statement was well-meaning, but it has unfortunately now become a saying that is used to body shame women. People say it in the hopes of guilting women into eating foods that are only non-fat and suitable for people who are on wildly restrictive diets. This is an awful precedent that has been set because the saying itself does have validity. The fact of the matter is that when you eat unhealthily then, the chances are you will be unhealthy you put junk in your body then it is going to break down. Maybe not today or even tomorrow. But, it probably is going to happen.

The same goes for DCIS. While your genes and biological makeup do play a role, some things will increase your risk. These come in the form of lifestyle choices. If you drink a lot of alcohol, then your risk is heightened and not just for DCIS, but for other more invasive breast cancers as well. If you are maintaining an unhealthy weight, then your risk increases. The point is that if you are healthy, then you should stay healthy.

Breastfeeding may still be possible

One cannot imagine what it is like for a woman to lose her breasts. Breasts are not just something that has been overly sexualized. They are part of a woman’s body. She watches them grow. She feels them ache when she is menstruating. They represent a very real connection to what it is to be a woman. They are the things that she will go on to feed her child. They are objects of femininity and nourishment. To not be able to breastfeed your child because they have been taken away is like being stabbed directly in the heart.

Luckily, however, DCIS does not mean that a woman will lose her breasts and it does not say that she will not be able to breastfeed when she does want children. Granted this is not with all cases. But, if a woman has only had surgery to remove cancer, then she should be able to produce milk and breastfeed. If, however, she has had radiation and chemotherapy, then a fertility doctor should be consulted. The point is that there is always hope. A DCIS diagnosis does not mean that breastfeeding is impossible.